RIGHT-OF-WAY PERMIT APPLICATION CHECK LIST

THE FOLLOWING ARE CRITERIA FOR SUBMITTALS OF RIGHT-OF-WAY PERMITS

NO RIGHT-OF-WAY PERMITS WILL BE ISSUED UNTIL CRITERIA BELOW HAVE BEEN MET

1.  THE CONTRACTOR/EVENT COORDINATOR SHALL SUBMIT A DETAILED DRAWING OF THE WORK AREA AND TRAFFIC CONTROL PLAN. THE DRAWING SHALL BE SITE SPECIFIC AND INCLUDE MAINTENANCE OF TRAFFIC PLANS FOR ALL CONSTRUCTION/ROAD CLOSURES WITHIN THE RIGHT-OF-WAY INCLUDING TRAVEL LANES, TURN LANES, MEDIANS, SIDE STREETS, SIDEWALKS, AND ALL INTERSECTION WORK IMPACTED BY THE CONSTRUCTION PROJECT. SIGNALIZED INTERSECTIONS MAY REQUIRE ADDITIONAL TRAFFIC CONTROL PLAN APPROVAL TIME DUE TO REVIEW BY THE LEE COUNTY DEPARTMENT OF TRANSPORTATION (D.O.T.).

2.  THE DETAILED DRAWING MUST SHOW ALL SIGNS, DEVICES, TAPERS AND BUFFER ZONES LISTING THE PROPER DISTANCES AND LENGTHS PER THE MANUAL OF UNIFORM TRAFFIC CONTROL DEVICES (MUTCD) AND FLORIDA DEPARTMENT OF TRANSPORTATION (ROADWAY AND TRAFFIC DESIGN STANDARDS INDEX SERIES 600).

special events:

·  For local roadways: a certified barricade company should prepare the drawings.

·  For Arterial/collector roadways: engineered drawings must be submitted

3.  INCLUDE A BRIEF DESCRIPTION OF THE WORK BEING DONE, ALONG WITH THE STARTING AND COMPLETION DATES, WORK HOURS, NIGHT ACTIVITY, ETC.

4.  LIST A 24-HOUR EMERGENCY TELEPHONE NUMBER OF THE SUPERVISOR ON THE JOB RESPONSIBLE FOR MAINTAINING THE MOT.

5.  THE CONTRACTOR / PERMITTEE IS RESPONSIBLE TO COMMUNICATE WITH THE BARRICADE COMPANY ANY MATTERS CONCERNING DEFICIENCIES WITH THE TRAFFIC CONTROL PLAN AT ANY TIME DAY OR NIGHT. THE CONTRACTOR SHALL BE IN POSSESSION OF THE BARRICADE COMPANY'S 24-HOUR NUMBER. NOTE: THE BARRICADE COMPANY'S REPRESENTATIVE SHALL BE CERTIFIED BY THE AMERICAN TRAFFIC SAFETY SERVICES ASSOCIATION (ATSSA) OR THE INTERNATIONAL MUNICIPAL SIGNAL ASSOCIATION (IMSA).

APPLICANT'S COPY

PW-1001 Right-of-Way Permit Application Checklist

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APPLICATION / ick Here for Date Accepted"

PW-1001 ROW Permit

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Permit number:

CITY OF CAPE CORAL

PUBLIC WORKS DEPARTMENT

RIGHT-OF-WAY CONSTRUCTION PERMIT

APPLICANT TO COMPLETE

UTILITY INSTALLATION / ROADWAY CONNECTION / SPECIAL EVENTS OTHER
NAME OF APPLICANT: / CONTRACTOR:
MAILING ADDRESS: / LICENSE NO:
PHONE NUMBER: /
CONTACT PERSON:
EMAIL ADDRESS: / CITY REGISTRATION NO:
FOR THE PURPOSE OF CONSTRUCTING OR INSTALLING
UNDERGROUND UTILITIES / CABLE TV / OTHERS:
TELEPHONE LINE / JACK AND BORE
OVERHEAD UTILITIES / CATCH BASIN / SPECIAL EVENTS
OVERSIZE / VEHICLE TRANSPORT / TURN LANE
POWER LINES / OPEN CUT
WATER LINES / WIDENING / ESTIMATED COST OF PROJECT:
DRAINAGE CULVERTS / CURB AND GUTTER / $
SEWER LINES / NATURAL GAS/LPG
LOCATION:
ESTIMATED CONSTRUCTION TIME: / (DAYS)
THE WORK HEREIN DESCRIBED, IF PERMITTED, WILL BEGIN ON:
ADDITIONAL INFORMATION:
FOR CITY USE ONLY
ADDITIONAL REQUIREMENTS / APPROVED / REJECTED
AS-BUILT PLANS (SKETCH) / BY:
DENSITY REPORTS
DATED ISSUED: / / REJECTED:

PW-1001 ROW Permit

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NOTE: SEE CONDITIONS OF PERMIT

PW-1001 ROW Permit

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CONDITIONS OF PERMIT

Failure to maintain the approved Traffic Control Plan (TCP) will result in revocation of the Right-of-Way Permit and or citation (arrest) in accordance with City of Cape Coral Ordinance (Chapter 12 Article 5, Section 12-54 to 12-59).

Driveways must remain accessible in work areas.

All emergency services must be notified of detours and lane closures.

The construction or maintenance shall not interfere with the property rights of another property owner.

All work shall be done in keeping with standards of City of Cape Coral, Public Works Department.

All materials and equipment shall be subject to inspection by the City Public Works Department.

During the construction, all safety regulations of the City Public Works Department shall be observed and the City shall be relieved of all responsibility from damage or liability of damage of any nature arising from work authorized under this permit.

All public and private property shall be restored to an original condition as far as is practical, to the satisfaction of Public Works Department.

The attached sketch covering details of this installation shall be made a part of this permit. If additional plans are required, they shall become a part of this permit.

It is expressly stipulated that this permit is a license for permissive use only and that the placing of facilities or equipment upon public property pursuant to this permit shall not operate to create or to vest any property right in said holder.

Whenever necessary for construction, repair, improvement, alteration, or relocation of all or any portion of said highway or Right-of-Way as determined by the City, any and all poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately removed from said highway or right-of-way, or reset or located as required by the City, and at the expense of the holder.

Sodding, grassing and/or seeding of Right-of-Way that have been disturbed is required after completion of all work.

Contractor or homeowner must contact Public Works Department to set grade stakes before sod can be installed.

To process your Right-of-Way Permit Application, please submit completed form to:

City of Cape Coral, Public Works Department

Attention: Jim DePatie

815 Nicholas Parkway E.

Cape Coral Florida, 33990

or email to:

Questions on this form? Please call (239)242-3295.

Contact Lee County Traffic Signal Maintenance for locates at 239-674-7600.

One Call No Cuts @ 811 / 1-800-432-4770 and City Utilities @ 574-0852

PW-1001 ROW Permit/Conditions

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